Melding mental health services

Thursday

Mar 14, 2013 at 12:01 AM

Six southeast Iowa counties presented the Department of Human Services with a letter of intent to form a region to provide mental health and developmentally disabled services.

The counties' central point of coordination administrators and supervisors traveled to Des Moines on Wednesday to deliver the letter and meet with area lawmakers and DHS staff to ask questions as the state's redesign of the mental heath system continues to take shape.

While all of the CPCs' concerns have not been addressed fully, Des Moines County CPC Administrator Ken Hyndman said the meeting was productive.

"I feel like it was definitely worth our time to express some of our concerns we see at the local level and to hear a little bit more about what they're planning," he said after the meeting with area lawmakers, as well as DHS Director Chuck Palmer and Mental Health and Disability Service Division Administrator Rick Shults.

Area lawmakers said they did little talking but instead listened to the dialogue between the county representatives and DHS staff.

"We had a, I think, a real good meeting, nice discussion," said Rep. Dave Heaton, R-Mount Pleasant, who leads the budget subcommittee for Health and Human Services. "I thought it was a very informative meeting, and everybody kind of walked away with their questions answered and feeling satisfied."

He said the county CPC administrators left with the understanding DHS staff member are willing to continue talking and answering questions when possible.

Rep. Tom Sands, R-Wapello, agreed the meeting was productive.

He said some of the concerns brought from the counties is simply that the rules still are being written so not all of the answers are available Sands said the worry is compounded by the fact county offices are moving ahead to form a region by the July 1 deadline, and they don't want to get halfway into planning and discover they are on the wrong side of rules that haven't been written yet.

Hyndman said it doesn't seem like the department is making "very fast" progress on rules, but he acknowledged its staff didn't promise a completion date.

Still, Sands commended the CPCs for the work done so far.

"I think that our counties and the different supervisors and the CPCs have worked extremely hard to form this region. I think they are going about it in the right way," he said.

While Hyndman was happy to hear the department acknowledge not all the rules have been written, he continues to have concerns about how each piece will come together.

He worries if the state does not expand Medicaid and transportation is not a core service, there could be issues with getting people to appointments. While the alternative to expansion may make Community Health Centers an option for people, Hyndman said the local CHC does not provide behavioral health services.

Heaton said, though, the regions once formed may be able to contract with each other for various services.

Hyndman said he also asked what will happen if the county's management plan ends before the regional management plan is written. He said he was told the county management plan may be able to be used for another year.

But that led to new concerns.

He said the county's plan is outdated in some respects and he has spent the last year telling patients about upcoming changes under the redesign law.

Hyndman said he also must have contracts with providers signed by July 1, but he doesn't know what core services to put into contracts.

While Taylor was optimistic about being able to use the Women's Unit at Mount Pleasant Correctional Facility -andnbsp;the women will be moved to a women's prison in Mitchellville -andnbsp;for mental health services, Hyndman said it is possible but it may not be eligible for federal dollars through Medicaid.

"We need the space. It would be great to have the jobs, to have the mental health jobs back in Mount Pleasant," Taylor said. "It also makes sense to reclaim that building rather than let it sit empty."

Hyndman said, though, Medicaid will fund residential care facilities only if it has 16 beds or less. He said, though, once the state begins to provide subacute care, it should free up some beds for mental health patients.

The proposed southeast Iowa region for mental health and disability services is made up of Des Moines, Henry, Keokuk, Lee, Louisa and Washington counties. Van Buren County initially considered joining but now is opting to try to operate on its own.

Hyndman said the DHS staff assured if issues arise with the way the region was set up in the letter of intent, it will work with the counties to ensure they can continue to work together. Having delivered the letter of intent, Hyndman said the region's CPC staffs will begin writing an intergovernmental agreement.

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